| Course | NR 570 Common Diagnosis and Management in Acute Care Practicum |
|---|---|
| Week | 8 |
| Paper type | Portfolio with commentary |
| Length | About 1,150 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Acute Care NP (AGACNP) |
| Updated | October 2026 |
Free sample paper for NR 570 Week 8
Common Case Portfolio: Six Pieces From One Bowel Obstruction Admission, Gathered to Show That Every Management Line Names Why It Fits This Patient
Student Name
College of Nursing, Chamberlain University
NR 570: Common Diagnosis and Management in Acute Care Practicum
Instructor Name
Month Day, Year
Common Case Portfolio: Six Pieces From One Bowel Obstruction Admission, Gathered to Show That Every Management Line Names Why It Fits This Patient
Contents
Table 1
Portfolio Contents in Order
| Item | Week | What it is | Chosen to show |
|---|---|---|---|
| 1 | Week 2 | Case paper, adhesive small bowel obstruction | Management written with a reason for each element |
| 2 | Week 3 | Guideline concordance write-up | Record compared with the Bologna guidelines, including elements not raised |
| 3 | Week 4 | Admission note critique | Replacement wording for an admission note |
| 4 | Week 5 | Three progress notes | Plans with intervals and findings carried day to day |
| 5 | Week 6 | Discharge summary draft | Changes, owners and the forward half first |
| 6 | Week 7 | Supervised encounter write-up | One overnight visit, kept to what was known then |
All six items concern one composite patient, a 74-year-old admitted with an adhesive small bowel obstruction that settled without an operation. They appear in the order the course produced them, each with its original title and with earlier instructor comments removed.
How the Pieces Were Prepared
Each item was reformatted to the same font, margins and heading style so the set reads as one document. Original titles were kept, so a reader can match each item to the gradebook, but assignment headers and instructor comments were removed. Every item was checked again for names, dates, unit names and anything else that could point to a real person or place. Item 6 is shorter than the others because the classroom template limits each field, and it is included at its original length rather than expanded.
The Claim
The standard this portfolio claims is narrow: in common cases, every management line I write names why it fits this patient, not only what the guideline says. I chose this standard because a common diagnosis invites a list of correct actions that could be copied into any chart, and the course rubric for this term marked that as knowledge rather than practice.
Where the Standard Is Visible
In Item 1, the management section gives ten numbered elements, and each carries a reason tied to the patient. Element 2 picks a balanced crystalloid, gives the "chloride-losing alkalosis" found on the first blood work as its reason, and then qualifies its own evidence by noting that most people in the cited trial were not vomiting. Element 10 ties walking to the patient's baseline of a mile a day rather than to a general recommendation about mobility.
In Item 4, each plan carries an interval and a reason. On day 2 the plan gives a time for the film and says what would happen if contrast remained in the small bowel, which makes the reason for the film explicit. On day 3, lisinopril is restarted "tomorrow if creatinine holds," linking the medicine to the kidney value that caused it to be held. That plan follows the guideline's sequence for nonoperative care (ten Broek et al., 2018), but the reason for each timing is the patient's own.
In Item 6, the plan explains why no antihypertensive was given in three specific reasons: no sign of organ damage, kidneys already injured, and a cause that could be reversed at the bedside. That is the standard at its clearest, because the most defensible decision in the encounter was a decision not to act, and it needed its reasons more than any order did.
In Item 2, the standard appears in a different form: the column headed "reason where they differ" makes the write-up explain the one partial row, a lactate drawn late, instead of simply marking it. That column exists because a concordance table without reasons judges people, and the standard I am claiming is about explaining rather than judging.
In Item 5, the medication block states the reason for each change, including stopping over-the-counter ibuprofen because it contributed to the kidney injury. A summary that lists medicines without reasons forces the next clinician to reconstruct them, and a review of discharge communication found important information regularly missing from summaries (Kripalani et al., 2007).
Where the Standard Slipped
The standard did not hold everywhere. In Item 1, element 8 justifies clot prevention by bed rest and dehydration alone. That is a reason, but a thin one; it would fit nearly every admitted patient, and it does not mention the kidney value, which affects the choice of agent. In Item 4, the day 2 plan says "Walk the hall twice today," with no link to the baseline in Item 1, even though that link was the whole point of element 10 in the case paper. And Item 3, the critique, is about someone else's note, so it shows that I can recognize a missing reason, not that I always supply one.
One Look Across the Set
Read together, the pieces show a pattern I did not expect. The reasons are strongest where a decision was uncertain or unusual, such as withholding an antihypertensive or choosing a fluid, and weakest where the action was routine, such as clot prevention and walking. That is the opposite of where common cases need them most, because routine actions are the ones most often copied forward without thought. The baseline function line appears in Items 1, 5 and 6 and was the thread that made the walking plan and the discharge comparison possible; in older adults, the gap between function before admission and at discharge is common and often persistent (Covinsky et al., 2003).
What I Would Change Next Term
Two changes follow from the slips. First, routine orders will get a reason specific to the patient, even when the action is standard: a clot prevention line will name the kidney value and the bleeding risk that shaped the choice of drug, and a walking order will refer to the baseline recorded on admission. Second, every progress note will carry the baseline function line forward in the subjective block, not only the case paper and the discharge summary, so the comparison is visible each day rather than only at the end.
What the Set Does Not Show
The portfolio follows one patient who did well. It does not show a common case that went badly, an operation or a decision made under real time pressure, apart from the overnight page. It does not show how my reasoning compares with the guideline on cases outside the obstruction pathway. And because all six pieces describe one admission, it cannot show whether the standard holds across different patients; the next set should include at least one patient whose course did not follow the plan, so the standard is tested where reasons are hardest to write.
References
Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., Burant, C. J., & Landefeld, C. S. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: Increased vulnerability with age. Journal of the American Geriatrics Society, 51(4), 451-458. https://doi.org/10.1046/j.1532-5415.2003.51152.x
Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah, P., & Baker, D. W. (2007). Deficits in communication and information transfer between hospital-based and primary care physicians: Implications for patient safety and continuity of care. JAMA, 297(8), 831-841. https://doi.org/10.1001/jama.297.8.831
ten Broek, R. P. G., Krielen, P., Di Saverio, S., Coccolini, F., Biffl, W. L., Ansaloni, L., Velmahos, G. C., Sartelli, M., Fraga, G. P., Kelly, M. D., Moore, F. A., Peitzman, A. B., Leppaniemi, A., Moore, E. E., Jeekel, J., Kluger, Y., Sugrue, M., Balogh, Z. J., Bendinelli, C., . . . van Goor, H. (2018). Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the World Society of Emergency Surgery ASBO working group. World Journal of Emergency Surgery, 13, Article 24. https://doi.org/10.1186/s13017-018-0185-2
What the NR 570 Week 8 assignment asks for
The Week 8 portfolio asks you to collect pieces from the term and add a commentary of a few pages. Expect a contents page, the pieces in a stated order, and commentary either before the set or between items, as your section directs. Each piece needs a label with what it is, which week produced it and why it was chosen. The commentary should name the standard you are claiming, point to specific places in the pieces where it shows, and admit where it slipped. Formatting should be consistent across the set, with old headers and instructor comments removed. Many rubrics include a look across the whole set and a statement of its limits.
How this NR 570 Week 8 example is built
The sample opens with a six-row contents table giving each item's week, type and purpose, followed by a note on how the pieces were formatted and checked for identifiers. The claim is stated in two sentences: management lines name why they fit this patient. The commentary then points to exact places in four items, such as the fluid choice in the case paper and the decision against an antihypertensive in the encounter write-up. A section names two slips, a thin reason for clot prevention and a walking plan with no link to baseline. A cross-set pattern, two changes for next term and the portfolio's limits complete it.
Reading the NR 570 Week 8 grading rubric
Completeness is often the heaviest row, so the sample lists every required item in the contents table. Commentary is marked on whether it claims something and supports it; describing each piece in turn earns little, while pointing to specific lines earns most. Admitting where the standard slipped adds credibility and usually fills a reflection row. Consistent formatting carries more weight than writers expect. The cross-set look is marked for finding a pattern, here strong reasons on unusual decisions and thin ones on routine actions. A limits section that admits the set follows only one patient who did well completes the final criterion. Two named changes for next term show the commentary has a use beyond this grade.
Common NR 570 Week 8 mistakes, and how to avoid them
The most frequent NR 570 Week 8 loss is a missing piece, which costs the completeness row outright. Next is commentary that describes each item and claims nothing, reading like a table of contents in sentences. Pieces pasted in with old headers, grades and instructor comments lose presentation points. Inconsistent fonts and headings also cost. Portfolios showing only successes miss the reflection rows. Commentary that summarizes instead of quoting gives the marker nothing to check. If your section requires different pieces, send the list and your chosen standard; a portfolio commentary can be drafted that points to exact places in your own work. Choose pieces that test your claim, not only those that flatter it.
Get a NR 570 Week 8 example written to your instructions
Tell the desk which pieces the set must include, how the commentary is weighted and what the contents page has to show. A custom portfolio piece comes back inside 24-48h, assembled as a claim with the items arranged under it. The first one is free, and a cover sheet or labeling scheme from your section gets used exactly.
More NR 570 papers and AGACNP samples
- NR 570 Week 1: Baseline Function Discussion Post
- NR 570 Week 2: Bowel Obstruction Case Paper
- NR 570 Week 3: Guideline Concordance Write-Up
- NR 570 Week 4: Admission Note Critique
- NR 570 Week 5: Progress Note Sequence
- NR 570 Week 6: Discharge Summary Draft
- NR 570 Week 7: Supervised Encounter Write-Up
- NR 569 Week 8: Diagnostic Accuracy Review
- NR 567 Week 8: ICU De-Escalation Plan
NR 570 Week 8 questions, answered
Which pieces should go in?
Whatever the assignment lists. If the choice falls to you, take items that support one claim instead of the ones you scored best on, since the claim is what the commentary has to prove. A weaker piece included because it shows a specific thing, with a sentence explaining that, tends to earn more than a strong piece included for no stated reason.
Should the pieces be revised before they go in?
Check your instructions, because sections split on this. Some want the work exactly as submitted, with the commentary handling what you would change now, and some expect revision with the original attached. Where revision is allowed, say in the commentary what changed and why, since the change is itself evidence of the standard being claimed.
My commentary keeps turning into a summary of each item.
That is the usual first draft. A finished example handles it by stating the claim first and then pointing at the two or three places in the items that prove it, instead of walking the folder front to back. Anything in the commentary that would still be true if a different piece sat in its place is not doing work.
Where can I find a free NR 570 Week 8 sample paper?
The full portfolio, with its contents table, stated claim and commentary pointing to exact lines in six pieces, is published on this page.
What standard does the NR 570 Week 8 portfolio claim?
That every management line in a common case names why it fits this patient, not only what the guideline says, with two places where that standard slipped.